JACC. Case reports · 2026
Unexplained Supraventricular Tachycardia and Myocardial Injury After Bitter Orange Supplement Use in a Young Woman.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Plaitis Aristides, Grigoraki Evangelia, Karakosta Maria, Gardikioti Vasiliki, Kalesi Alkistis-Eleni, Kalivi Anna, Giannakodimos Alexios, Barmpagiannis Dimitrios, Theodosis-Georgilas Anastasios, Patsourakos Nikolaos
Аннотация
BACKGROUND: Bitter orange (Citrus aurantium) is a common ingredient in weight-loss supplements and contains p-synephrine, a proto-alkaloid with sympathomimetic properties. Various cardiovascular adverse events have been reported after its use.
CASE SUMMARY: A 38-year-old woman without cardiovascular risk factors presented with palpitations, atypical chest pain, and vomiting after 1 week of weight-loss-supplement use. Electrocardiography showed a supraventricular tachycardia, successfully terminated with 6 mg of intravenous adenosine. High-sensitivity troponin I rose from 17.9 to 1,395.7 ng/L. Transthoracic echocardiography was unremarkable, computed tomography pulmonary angiography excluded pulmonary embolism, and coronary angiography showed no obstructive coronary artery disease. Cardiac magnetic resonance demonstrated nonspecific late gadolinium enhancement.
DISCUSSION: This case highlights a possible association between bitter orange supplement use and supraventricular tachycardia with myocardial injury in the absence of obstructive coronary disease. The likely mechanism involves p-synephrine-mediated sympathetic stimulation, with possible demand ischemia and/or vasospasm.
CASE SUMMARY: A 38-year-old woman without cardiovascular risk factors presented with palpitations, atypical chest pain, and vomiting after 1 week of weight-loss-supplement use. Electrocardiography showed a supraventricular tachycardia, successfully terminated with 6 mg of intravenous adenosine. High-sensitivity troponin I rose from 17.9 to 1,395.7 ng/L. Transthoracic echocardiography was unremarkable, computed tomography pulmonary angiography excluded pulmonary embolism, and coronary angiography showed no obstructive coronary artery disease. Cardiac magnetic resonance demonstrated nonspecific late gadolinium enhancement.
DISCUSSION: This case highlights a possible association between bitter orange supplement use and supraventricular tachycardia with myocardial injury in the absence of obstructive coronary disease. The likely mechanism involves p-synephrine-mediated sympathetic stimulation, with possible demand ischemia and/or vasospasm.